Abstract
BackgroundGray-scale, B-mode ultrasound (US) imaging is part of the standard clinical procedure for evaluating thyroid nodules (TNs). It is limited by its instrument- and operator-dependence and inter-observer variability. In addition, the accepted high-risk B-mode US TN features are more specific for detecting classic papillary thyroid cancer rather than the follicular variant of papillary thyroid cancer or follicular thyroid cancer. Quantitative ultrasound (QUS) is a technique that can non-invasively assess properties of tissue microarchitecture by exploiting information contained in raw ultrasonic radiofrequency (RF) echo signals that is discarded in conventional B-mode imaging. QUS provides quantitative parameter-value estimates that are a function of the properties of US scatterers and microarchitecture of the tissue. The purpose of this preliminary study was to assess the performance of QUS parameters in evaluating benign and malignant thyroid nodules.MethodsPatients from the Thyroid Health Center at the Boston Medical Center were recruited to participate. B-mode and RF data were acquired and analyzed in 225 TNs (24 malignant and 201 benign) from 208 patients. These data were acquired either before (167 nodules) or after (58 nodules) subjects underwent fine-needle biopsy (FNB). The performance of a combination of QUS parameters (CQP) was assessed and compared with the performance of B-mode risk-stratification systems.ResultsCQP produced an ROC AUC value of 0.857 ± 0.033 compared to a value of 0.887 ± 0.033 (p=0.327) for the American College of Radiology Thyroid Imaging, Reporting and Data System (ACR TI-RADS) and 0.880 ± 0.041 (p=0.367) for the American Thyroid Association (ATA) risk-stratification system. Furthermore, using a CQP threshold of 0.263 would further reduce the number of unnecessary FNBs in 44% of TNs without missing any malignant TNs. When CQP used in combination with ACR TI-RADS, a potential additional reduction of 49 to 66% in unnecessary FNBs was demonstrated.ConclusionThis preliminary study suggests that QUS may provide a method to classify TNs when used by itself or when combined with a conventional gray-scale US risk-stratification system and can potentially reduce the need to biopsy TNs.
Highlights
Thyroid nodules (TNs) occur in 50% of the older adult population; only about 5% of TNs are malignant [1, 2]
Since the Quantitative ultrasound (QUS) and B-mode-US characteristics depend on different aspects of the US RF echo from a TN, we explored the potential of QUS in combination with an existing TN riskstratification system to determine if the number of biopsies could have been further reduced in this cohort
Thirty-four TNs were excluded when the signal-processing software detected an error in the data being analyzed and blocked further processing
Summary
Thyroid nodules (TNs) occur in 50% of the older adult population; only about 5% of TNs are malignant [1, 2]. To improve the predictive value of B-mode imaging, classification systems such as the American College of Radiology Thyroid Imaging, Reporting and Data System (ACR TI-RADS) and the 2015 American Thyroid Association (ATA) TN risk-stratification system have been developed [3, 6]. These systems identify high-risk US features such as hypoechogenicity, taller-thanwide configuration, calcification, irregular margins and abnormal lymph nodes to determine suspicion for malignancy. Gray-scale, B-mode ultrasound (US) imaging is part of the standard clinical procedure for evaluating thyroid nodules (TNs) It is limited by its instrument- and operatordependence and inter-observer variability. The purpose of this preliminary study was to assess the performance of QUS parameters in evaluating benign and malignant thyroid nodules
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
